Epidemiology of invasive meningococcal disease in Germany, 2002–2010, and impact of vaccination with meningococcal C conjugate vaccine

Abstract

SummaryObjectives: To analyse serogroup (Sg)-and finetype-specific invasive meningococcal disease burden (IMD) in Germany, 2002Germany, -2010, with emphasis on effects of vaccination with conjugate SgC vaccines targeting one-year old children since 2006, including individual-based catch-up to 17 years of age.Methods: Serogroup-and age-specific IMD incidence and trends were calculated using statutory surveillance data. The national reference laboratory performed genetic finetyping. Vaccination uptake data were obtained from school entry surveys and prescription monitoring. Results:In persons <25 years, SgB and SgC IMD incidence decreased significantly from 0.63 to 0.32/100,000 and 0.26 to 0.10/100,000, respectively. The decline was significantly steeper for SgC than SgB in 1-5 year-olds, the primary vaccination target group, but not other ages. The slope of the SgC incidence curves was similar before and after vaccination implementation in all age groups; however, the decrease in incidence was steeper in states with higher vaccination uptake. Declining SgC incidence was associated with decreased SgC finetype diversity. An increase in SgY incidence was limited to adults. Conclusions:Results suggest effects of the German SgC vaccination strategy are limited, although interpretation is complicated by already low and decreasing incidence before vaccination. More effective use of vaccination resources might be achieved by rigorously targeting adolescents in addition to 1-year-olds.

Enhanced surveillance of invasive meningococcal disease in Canada, 2006-2011

“…An unusual shift in the genotype of invasive meningococcal C strains has also been observed, from predominantly ET15 type to ET-37 (non-ET-15) type (28). The overall case-fatality rate of IMD in Canada remained steady, as in previous years (8,17), and is comparable to that of other nations (29,30). IMD caused by serogroup C was much more severe than disease caused by serogroup B in terms of fatality.…”

Reduction inNeisseria meningitidisinfection in Italy after Meningococcal C conjugate vaccine introduction: A time trend analysis of 1994–2012 series

“…[11][12][13][14] As also observed by Mooney et al 14 , the reversal of the increasing trend of serogroup C related IMD was simultaneous with the timing of MCC introduction and, therefore, likely attributable to it. The impact of MCC was investigated in many other European and Italian regional studies [14][15][16][17][18][19][20][21][22][23][24][25] which showed an important decrease in N. meningitidis C related IMD and a vaccine effectiveness as high as 100% depending on the age group and on the time elapsed from vaccination. A downward trend in serogroup C related IMD was also confirmed by the European Center for Disease Prevention and Control (ECDC) in countries with MCC vaccination.…”

A cluster of invasive meningococcal disease in young men who have sex with men in Berlin, October 2012 to May 2013

“…N. meningitidis serogroups B (MenB) and C (MenC) predominate in Germany and affect mainly young children and adolescents [4]. Annual IMD incidence in Germany was 0.45 per 100,000 in the years 2010 to 2012 (n=386, n=369, n=354) [5].…”